go back

New Hampshire rates for HCPCS 72193

Computed tomography, pelvis; with contrast material(s)

Facilitymedian $81 · 10th–90th $52$2140%20%10th90th$81Professionalmedian $219 · 10th–90th $59$5010%5%10th90th$219$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$52.48 / $81.28 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $281.84 / $524.81
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$50.12 / $72.44 / $162.18
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$162.18 / $218.78 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$42.66 / $42.66 / $69.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $524.81 / $776.25
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$53.70 / $123.03 / $177.83
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$173.78 / $398.11 / $588.84
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $467.74 / $724.44
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $100.00 / $165.96
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $363.08 / $588.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $407.38 / $616.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$61.66 / $95.50 / $141.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $309.03 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $380.19 / $812.83
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$58.88 / $87.10 / $165.96
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$204.17 / $281.84 / $524.81
Well Sense
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$40.74 / $44.67 / $53.70